Other Views: VA scandal defies quick cures

With a scandal exploding around them, President Obama and Veterans Affairs Secretary Eric Shinseki have insisted on getting to the bottom of what happened before starting the cleanup.

Well, the first results arrived Wednesday, and they confirmed the need for a whole lot of mops.

At the VA hospital in Phoenix, the agency's acting inspector general found average waits of nearly four months to see a doctor, tricks by schedulers to hide those delays in official statistics and 1,700 veterans left off digital waiting lists altogether. Beyond Phoenix, the inspector general says such delays and coverups are a systemic problem. The investigation has expanded to 42 Department of Veterans Affairs facilities nationwide.

The damning new report touched off even more calls from Capitol Hill for Shinseki's resignation. But that oversimplifies the problem. The delays and coverups are symptoms of deeper, longstanding problems that go beyond one administrator and defy quick fixes. Veterans groups know them well, even if the public, Congress and Shinseki do not:

? The VA is grossly overloaded because it underestimated the deluge of patients it would face as aging Vietnam War veterans required more care and the wars in Iraq and Afghanistan sent a flood of grievously wounded veterans, many with traumatic brain injuries and post-traumatic stress disorder, into the VA's care.

? The VA is suffering from a shortage of primary care physicians - a broader national problem that it has failed to address. The VA has a vacancy rate of nearly 8 percent for those doctors, and its solution might charitably be described as self-deceptive. It set a 14-day limit for wait times, five days fewer than the average for the private sector. Then it failed to monitor its targets. The new IG report says average wait time in Phoenix is 115 days.

? The agency has too many hard-to-fire bureaucrats not directly involved in its health care mission. Since 2007, it has hired "way too many 'middle' people, often at salaries higher than the front-line" caregivers, says Richard Weidman, of the Vietnam Veterans of America. At the same time, the VA is run with a top-down command from Washington. Physician leaders familiar with local needs would be better able to meet goals.

Many veterans praise the care they get at VA facilities, but in a recent poll only 38 percent of Iraq and Afghanistan vets said the VA is doing a good or excellent job. To raise that number, VA leaders must first acknowledge that major problems exist. Judging by history, that will be a hurdle. Investigators have repeatedly reported since 2005 that workers were manipulating wait times. Nothing happened.

Nor can leaders blame a lack of money. The VA's budget has tripled since 2000 to $151 billion. The agency could use fewer but better managers, more private-sector safety valves to relieve backlogs and a plan to run the VA like a giant hospital system, not like a military installation.

Why Shinseki needed a new report to tell him all this after nearly six years in charge is a mystery - one that both he and the president need to explain.

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Other Views: VA scandal defies quick cures

With a scandal exploding around them, President Obama and Veterans Affairs Secretary Eric Shinseki have insisted on getting to the bottom of what happened before starting the cleanup.

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